Published online Oct 28, 2015. doi: 10.4329/wjr.v7.i10.350
Peer-review started: May 20, 2015
First decision: July 10, 2015
Revised: July 31, 2015
Accepted: August 20, 2015
Article in press: August 21, 2015
Published online: October 28, 2015
Processing time: 162 Days and 10.7 Hours
AIM: To investigate the prevalence of relevant incidental findings (RIFs) detected during routine abdominal contrast-enhanced computed tomography (CeCT).
METHODS: We retrospectively evaluated the reports of a consecutive series of abdominal CeCT studies performed between January and May 2013. For each report, patients’ age and sex, admission as inpatient or outpatient, clinical suspicion as indicated by the requesting physician, availability of a previous abdominal examination, and name of the reporting radiologist were recorded. Based on the clinical suspicion, the presence and features of any RIFs (if needing additional workup) was noted.
RESULTS: One thousand forty abdominal CeCT were performed in 949 patients (528 males, mean age 66 ± 14 years). No significant difference was found between inpatients and outpatients age and sex distribution (P > 0.472). RIFs were found in 195/1040 (18.8%) CeCT [inpatients = 108/470 (23.0%); outpatients = 87/570 (15.2%); P = 0.002]. RIFs were found in 30/440 (6.8%) CeCT with a previous exam and in 165/600 (27.5%) without a previous exam (P < 0.001). Radiologists’ distribution between inpatients or outpatients was significantly different (P < 0.001). RIFs prevalence increased with aging, except for a peak in 40-49 year group. Most involved organs were kidneys, gallbladder, and lungs.
CONCLUSION: A RIF is detected in 1/5 patients undergoing abdominal CeCT. Risk of overdiagnosis should be taken into account.
Core tip: A relevant incidental finding (IF) is detected in one out of five patients undergoing abdominal contrast-enhanced computed tomography. Thus, in clinical practice, we daily perform unconscious collateral screening for a number of abdominal diseases. Notably, a problem still exists about how to deal with these findings, as their detection can be stressful and potentially harmful for patients, also contribute to increase in health care costs. On the one hand we have the risk of overdiagnosis, on the other hand there is a risk of legal issues for not having reported and suggested further work-up for these IFs.